Individual
JOANN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2200 E SHOW LOW LAKE RD, SHOW LOW, AZ 85901-7881
(928) 368-8118
(928) 368-8121
Mailing address
PO BOX 1745, LAKESIDE, AZ 85929-1745
(928) 368-8118
(928) 368-8121
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN025318
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
497843
—
AZ
Enumeration date
02/08/2006
Last updated
12/06/2007
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